Physeal Fractures of the Distal Tibia

Leary, Jeffrey T.; Handling, Matthew; Talerico, Marcus; Lin, Yunfeng; Bowe, J. Andrew

doi:10.1097/bpo.0b013e3181a6bfe8

Cited by 133 publications

(76 citation statements)

References 18 publications

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“…The single patient who did have a low AOFAS score (83) had had a motor vehicle accident and presented with an open injury. High-energy trauma is a risk factor for poor clinical outcomes (Leary et al 2009). …”

Section: Discussionmentioning

confidence: 99%

“…Premature physeal closure causes growth disturbance (Barmada et al 2003). Leary has demonstrated that high-energy trauma is more likely to cause growth arrest than low-energy trauma or sports-related injuries (Leary et al 2009). In our study, 2 patients with premature physeal closure were in motor vehicle accidents, and 1 suffered a sports-related trauma.…”

Section: Discussionmentioning

confidence: 99%

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Percutaneous cannulated screw fixation for pediatric epiphyseal ankle fractures

et al. 2016

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BackgroundAnkle injuries are among the most common injuries in children. The aim of this study was to compare the efficacies of two percutaneous fixation methods after closed reduction in physeal ankle fractures.MethodsWe reviewed the cases of 24 patients with a mean age of 12.29 years; 16 were male, and 8 were female. Only patients with fractures of Salter-Harris types 2, 3, and 4 with displacements greater than 2 mm were included in the study. Patients were treated with closed reduction manipulation and percutaneous screw fixation. For each patient, either cannulated or headless full threaded compressive screws were used for percutaneous fixation. Radiological and clinical healing time, range of motion (ROM), American Orthopaedic Foot and Ankle Society (AOFAS) score and physeal arrest were then measured.ResultsThe mean follow-up time was 13 months. The mean time until cast removal was 3.5 weeks (range 2–5). A full ROM was achieved at an average of 5.7 weeks postoperatively (range 4–8). The radiologic healing time was 6.1 weeks (range 4–7). The patients’ clinical healing time averaged 6.8 weeks (range 5–8). Differences in radiologic healing time (p = 0.487), clinical healing time (p = 0.192), AOFAS score (p = 0.467), and complication rate (p = 0.519) between patients who received the headless compressive screw and those who received the cannulated screw for fixation were not statistically significant.ConclusionsWe demonstrate good clinical results with closed reduction and the percutaneous screw fixation method. Both cannulated and headless compressive screws can be used safely as a treatment method in physeal ankle fractures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Percutaneous cannulated screw fixation for pediatric epiphyseal ankle fractures

et al. 2016

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“…8, 38 The prognosis of SH-I and SH-II is the best, followed by SH-III then SH-IV. This is believed to correlate with the magnitude of initial traumatic force and the resultant physeal injury.…”

Section: Fracture Classificationmentioning

confidence: 99%

“…Repeated or delayed manipulation of physeal fractures should be avoided, so as to avoid additional damage to the physis with incurrent risks of premature closure. 38, 41 …”

Section: Treatment Strategiesmentioning

confidence: 99%

“…12, 38, 41, 49, 50 Fracture type, high energy trauma, higher initial displacement and multiple manipulation attempts are associated with growth arrest. 38 Barmada et al found higher rates of physeal arrest (60% vs. 17%) if a residual gap > 3 mm was seen at the physis for SH-I and II fracture patterns, 41 and recommended open reduction to remove entrapped periosteum in these settings.…”

Section: Complicationsmentioning

confidence: 99%

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Pediatric Ankle Fractures

Larson

2015

Foot and Ankle Clinics

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Synopsis Current clinical concepts are reviewed regarding the epidemiology, anatomy, evaluation and treatment of pediatric ankle fractures. Correct diagnosis and management relies on appropriate exam, imaging, and knowledge of fracture patterns specific to children. Treatment is guided by patient history, physical examination, plain film radiographs and, in some instances, CT. Treatment goals are to restore acceptable limb alignment, physeal anatomy, and joint congruency. For high risk physeal fractures, patients should be monitored for growth disturbance as needed until skeletal maturity.

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